Spine
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Combined prospective and retrospective. ⋯ The Threshold-Level method is highly sensitive and specific to deterioration in central motor function, and provides early warning of such an event. Conversely, in some cases the Presence-or-Absence method may fail to detect episodes of partial loss, and in other cases typically introduces a delay between the times when motor dysfunction begins to occur and when the response is lost (at which time an alarm is triggered). We conclude that use of the Presence-or-Absence alarm criteria for interpreting MEPs during surgery is often incompatible with the requirement for accurate and early warning of impending injury to central motor pathways, and should be avoided.
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Retrospective case series of 16 consecutive patients. ⋯ Scoliosis surgery is frequently necessary in PWS and is associated with high rate of complications. These are often related to specific features of this syndrome the surgeon should recognize and consider.
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Case Reports
Postoperative Trichosporon asahii spondylodiscitis after open lumbar discectomy: a case report.
A case report of Trichosporon asahii spondylodiscitis. ⋯ We present the first case of T. asahii spondylodiscitis, which developed unexpectedly in a healthy woman at the site of an open lumbar discectomy. We successfully treated the patient with surgical debridement and 5 months of fluconazole therapy.
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An outcome study of patients with neurogenic claudication and/or sciatica with hidden stenosis, detected only by axial loading of the lumbar spine (ACE) but not at the traditional unloaded examination (psoas relaxed position) during computed tomography (CT) myelography or magnetic resonance imaging (MRI), followed up after surgery. ⋯ According to this study, the results of surgery in hidden lumbar stenosis only detected by axial compression in extension during CT or MRI, are convincing and comparable with the results of surgical treatment for stenoses diagnosed by unloaded examinations.
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In this retrospective study, 20 spastic quadriplegic cerebral palsy (CP) patients with baclofen pumps, who underwent spinal fusion and instrumentation for neuromuscular scoliosis, were matched for weight, age, and type of fusion with patients without pumps. ⋯ CP patients with baclofen pumps who underwent spinal fusion had more complications compared with similar patients without pumps. There was no significant difference in surgical correction between matched pairs. Physicians and families should be aware of the increased risks of reoperation and rehospitalization after spinal fusion in the presence of baclofen pumps.